Information

  • TS Safety Contact Checklist

  • Observer's Name

  • Task being observed

  • Conducted on

  • INSTRUCTIONS:
    Introduce yourself
    Tell them you are doing an observation
    Tell them No Name No Blame
    Find a safe place to stand
    Observe for approximately 10 minutes
    Provide feedback, including positive feedback
    Find out Why they behaved at risk
    Finish with summaries of positive behaviour
    Ask for suggestions

Body Mechanics

  • Lifting activities as per TS procedure

  • Body positioning demonstrates sound ergonomics

  • Pinch points identified and kept clear of

  • Visual and special awareness demonstrated

  • Ascending/ descending

  • Record any at risk behaviour

PPE

  • Eye and face protection

  • Head protection used and appropriate for task

  • Hand protection used and appropriate for task

  • Fall protection used and appropriate for task

  • Hearing protection

  • Respiratory Protection

  • Body protection

  • Record any at risk behaviour

Job Factors

  • Works proceeding deliberately and safely

  • Clear on site communication system established

  • Plant and equipment used as per manufactures instructions

  • No go zones established and adequate for task

  • Isolations points as per SWMS and customer/industry practice

  • Record any at risk behaviour

Tools and equipment

  • Tool / equipment used appropriately and in good order

  • Correct selection of tool for the job

  • Tool / equipment condition

  • Ladders used appropriate, in good order and in test date

  • Record any at risk behaviour

Housekeeping

  • Waste materials stored, secured and removed from site

  • Site free from trip hazards

  • Hazardous substances managed appropriately. HAZMAT and MSDS available on site

  • Record any at risk behaviour

Feedback and suggestions

  • Positive Feedback

  • Suggestions to make the job safer (employee suggestions)

  • Observer's signature

  • Email completed safety contact to HSEQ Advisor

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.